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Nurses help to develop app to tackle patient deterioration at London trust

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Nurses at major London hospital have helped develop and roll-out a vital signs mobile app that could potentially save up to 60 lives per year by identifying and treating deteriorating patients earlier.

Nursing staff at Chelsea and Westminster Hospital NHS Foundation Trust have collaborated with IT services company ThinkShield on the project.

“We now know that every hour of every day the vital signs and fluid balance is up-to-date”

Barry Quinn

The app called ThinkVitals was initially launched across the trust’s acute assessment unit and, since late last year, has subsequently gone live across all adult wards after engagement with nursing staff.

Around 400 nurses and healthcare assistants are now able to input vital signs information into the app via hand held devices, replacing the use of paper-based observation charts.

The app’s algorithms use national early warning scores and National Institute for Health and Care guidelines to automatically identify patients most at risk, and requiring prompt or urgent treatment.

The information is also presented on large screens in the ward, displaying each patient’s location and condition, and allowing staff to easily tell those that need to be prioritised for clinical review.

A trust steering group actively invited and acted on regular feedback from clinical staff to try and increase its usability for them and also to minimise disruption to current workflows.

“The whole project design has had significant clinical input at all levels”

Gary Davies

Among the additional functions suggested and developed by nurses was a fluid balance module, which supports nurses and physicians to monitor patients’ input and output.

Dr Barry Quinn, assistant director of nursing at the trust, said: “We need to know constantly a patient’s vital signs and that their fluid balance is correct in order to direct care and treatment.

“We now know that every hour of every day the vital signs and fluid balance is up-to-date,” said Dr Quinn.

He added: “Nurses are experts in caring for people and need support with the growing need for IT in the clinical setting. Any IT system that is user friendly, is going to be much more attractive to nurses.”

Research by the trust has revealed that 95% of nursing staff who responded to an internal survey and that were using the newly-developed system reported that it was easy to use.

In addition, 84% of respondents to the survey, which was carried out earlier this year, welcomed the further digitalisation of all nursing documentation in the future.

Chelsea and Westminster Hospital NHS Foundation Trust

Exclusive: Nurses help develop patient monitoring app

Source: George Vasilopoulos/Chelsea and Westminster Hospital

The ThinkVitals app

Dr Gary Davies, clinical director for acute services at the trust, said: “The whole project design has had significant clinical input at all levels as well as the interface looking like the familiar previous paper observations forms.

“This has made it easy for nursing teams to adapt during the digitisation process,” he noted.

Tim Taylor, managing director of ThinkShield, added: “Our aim was to bring a very visual experience to nursing care, working closely with the frontline staff to make the application as highly intuitive and user-friendly as possible.

“This has helped minimise training especially during change over, and overall help to deliver a product for nurses’ everyday clinical needs,” he said.

A spokesman for the firm also told Nursing Times that the predicted figure of 60 patient lives saved a year was “based on a combination of factors of moving from a paper-based system, including reducing transcription errors and enabling clinicians to respond even quicker to patients at risk of reaching critical conditions”.

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